Claim form

Damage to your e-bike? Fill out the repair form below as completely as possible and we will contact you as soon as possible to repair the bicycle or to provide you with a replacement bicycle.

Claim form

Company name *

Name *

Company adress (street + number) *

Postal code *

City *

Email address *

Telephone number *

VAT number *

Chassis number e-bike *

Barcode at the left pedal on the frame starting with DLVRY

Battery serial number (in case of a defective battery)

Order date *

Damage front of e-bike

Damage middle of e-bike

Damage rear e-bike

Include photos of the damage (optional)

Drag & Drop Files, Choose Files to Upload Je kunt tot 10 bestanden uploaden.

The clearer we have an image of the damage, the better and faster we can help you.

In case of a defective battery, please add photos of all sides of the battery.

Other damage / additional comments